| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $806.00 | $2,505.00 | $8,017.00 | |
Aetna
| Professional | $764.00 | $1,426.00 | $7,197.00 | |
Martin's Point
| Facility | $657.00 | $2,422.00 | $8,017.00 | |
Martin's Point
| Professional | $800.00 | $1,541.00 | $7,197.00 | |
United
| Facility | $133.00 | $674.00 | $3,742.00 |